Zomorph prescribed strength

[missnevermind]

I have been on 60mg cocodomol 4 times a day for a long time now.
My doctor has just switched me to 30mg Zomorph instead and I am getting a lot more breakthrough pain than before.
Are the strengths comparable or will my doctor be trying to give me a lower dose to start with to see how little he can get away with. Have literally not been able to think of anything but the pain today.
I took my first dose yesterday at 7 and then this morning at 7 and paracetamol at regular intervals all day.
Do I need to grit my teeth till 'it kicks in' as it were.
I also take Gabapentin and then Oromorph for breakthrough pain

https://loros.co.uk/assets/opioiddoseeconversionguidanceev1aprill_2020.pdf

30mg of morphine is more than 240mg of cocodamol

It made me really nauseous, have you tried tramadol or Tapentadol? The latter works for me with oramorph for break through pain

What do you take it for?

Codeine is a crap drug because people metabolise it differently so it's difficult to know how much opiate you're getting.

Your language re: "what he can get away with" makes it sound like you have a dependency on these drugs.

@BoJoGoGoGo

Thanks. That's perfect. I had opened that already and missed the important bit I was after 🙄 The doctor offered the Zomorph so I just accepted his judgement.

@Burnedoutdr
You are quite right. I do have a dependancy on these drugs. I depend on them to help control the pain so I can function as a human being.

Nope,it sounds like the OP is well used to managing their pain and is used to medical professionals starting you off on the lowest dose possible.

OP,my mum had liquid morphine for breakthrough pain but sounds like you should speak to the GP again in case there's an alternative doseage.

Four x 60mg of codeine a day is equal to 24mg of morphine, and you are taking 30mg TWICE a day. So quite a lot more.

You sound very defensive and suspicious of the doctor which could be a sign of dependence. That’s not a judgement of you, but it’s important to acknowledge it if it’s the case, as being in denial will not help.

Any responsible doctor adheres to "start low and go slow" rather than whacking people on the highest dose of any drug. It's to avoid side effects.

I asked why you take them because best practice shows they shouldn't be used for chronic pain.

@Burnedoutdr and yet so many GP's prescribe them for chronic pain conditions...

Often because they're worn down by requests/threats to source them through the black market. It isn't right though.

@JamesBlond it was simply that I have no idea about the dosing structure.
In my head 30 x 2 x 4 is a lot more than 30 x 2.
I only started the Zomorph 24 hours ago and I am in quite a bit of pain at the moment but I am starting to think that is the start of a fibro flare.

I am suspicious of doctors. 😁. When I started the Gabapentin it was 100mg 3 times a day but as soon as I said it didn't seem to work it went straight up to 300mg 3 times a day, no further questions asked.

We used Zomorph for our post scoliosis repair kids. But with break through oramorph. As required.

@Burnedoutdr often?? I am on the same dosage codeine as the OP and I've never had to badger or threaten to get them

Zomorph is slow release - it releases the dose over 12 hours and is normally taken twice a day or you will get breakthrough pain. They would normally start it at 10-15mg twice daily rather than 30mg once daily. Did your GP give you anything for the breakthrough pain?

Sorry just read your other posts, are you on it twice daily?

Don’t try and compare milligrams between different drugs e.g. a dose of paracetamol is 1000mg and some drugs are 1-2mg a dose.

You're on that cocktail for Fibromyalgia? Jesus christ. That is a serious problem.

Yes, which is what I said.

I don’t blame you for being suspicious OP, I had terrific back pain for months and was made to feel like an addict. I thought I was going mad at one point, had me questioning myself whether I had imagined the pain. I’d leave the painkillers off as I was so paranoid and then I’d be in agony. I had a herniated disc and after my butt went numb I was rushed for emergency surgery as I had Cauda Equina. One month after the surgery I’d weaned myself off all painkillers bar paracetamol!

I was 4 months clear of all painkillers when I had a traumatic accident (major, 7 broken ribs, broken arm, brain injury, and damaged nerves) and now I’m back in the painkillers. Back to being made to feel like I’m asking for the moon again.

I know some painkillers need to build up in your system though, so are zomorph that type?

Just remember that mostly, opiates for people with chronic pain are not actually helping the pain. They’re just stopping withdrawal symptoms! Like putting on tight shoes so it feels nice when they’re taken off. Opiates tend to make people feel better about the pain, rather than actually getting rid of the pain.

@missnevermind
Zomorph is a slow release version so should give you relief for longer but if you're using it like codeine for break through pain it won't work well.

Your GP hasn't informed you well on how to use it. Go back and ask for more info. Or if you can't face it. Google. Zomorph is very strong but as slow release it will take a few days to work due to the slow release. It's very different to instant relief from codeine.

To the rest of you coming on here and suggesting op is drug seeking and addicted and opioids shouldn't be used for chronic pain need to fuck right off.
Clearly none of you have the slightest idea about unbearable and unending pain. Pain that won't end or stop until you die.

How insensitive and rude and patronising and disrespectful. Piss off with that.

And yes I'm up at stupid o'clock in pain. Mine is spondyloarthritis. Fun facts like: joint pain in lower limbs, enthesitis (look that up. It's nasty), inflammatory bowel disease (yes it can also move on to your intestines), and of course spinal pain.

The Pain Management Consultant I see said this about opioid for pain relief: "you will always be in pain so you won't ever be able to come off them (codeine). Codeine is a better choice than many anti inflammatories as it doesn't cause damage to your heart, liver, kidneys or intestines. And a better choice than gabapentine as your pain isn't neuropathic in origin plus gabapentine turns your mind to mush and will leave you without any quality of life".

Op. The response you've had here from some is so typical. It is the sort of thing which adds to the burden of disease. It's depressing. I avoid talking about my pain even to those closest to me because of reactions like you've had here. It's too hard to hear.

I'm about to start medical cannabis for pain. When the pain management consultant suggested it I thought he was suggesting something illegal. But no. It is available via private prescription. It has taken me a while to pluck up courage due to the stigma around cannabis. But as I can see here, there's stigma and pearl clutching around codeine as well.

If you have any funds available, perhaps try it? I'll let you know how I get on.

always the judgement from know it alls who don't live with chronic, life destroying pain

Meaning what? How is that helpful?

This thread is awful.

@thesootherfairy ooh I’m due an assessment for medical cannabis use. I’d love to hear how it goes for you

Thank you. You have given me a lot of important information there 😊
But just as importantly on this thread you have made me feel validated for the amount of drugs I have to take.
I am feeling better today so the slow release and long time to get into my system has finally happened so I can stop worrying about the dosage now.
I also am on painkillers for life. We don't worry about addiction and having to wean off them because I will never be cured or pain free so it will never be an issue. I agree about the gabapentin turning your brain to mush. As soon as I started to take them I was having to fish about for words.
I don't know anything about medical cannabis but I started taking CBD oil as soon as it became legal and found it to be a great relief with the pain but also a side effect was that it helps with my psoriasis.
I haven't had quite so much breakthrough pain today so maybe we are sorted again for now 😊

@missnevermind
I was having a moment.
I just get so fed up with it all and the ignorance. 😡

@StarCourt
Will do. I really hope it works.